The American journal of the medical sciences
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Comparative Study
Comparison of diabetic ketoacidosis in patients with type-1 and type-2 diabetes mellitus.
Diabetic ketoacidosis (DKA) occurs most often in patients with type 1 diabetes, however patients with type 2 diabetes are also susceptible to DKA under stressful conditions. The aims of our study were to evaluate and compare the clinical and biochemical characteristics and outcomes of type 1 versus type 2 diabetes mellitus (DM) patients with DKA. ⋯ DKA in patients with type-2 DM is a more severe disease with worse outcomes compared with type-1 DM. Advanced age, mechanical ventilation and bed-ridden state were independent predictors of 30-day mortality.
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Chronic obstructive pulmonary disease (COPD) causes a high rate of morbidity worldwide and predicting a bacterial cause of an exacerbation of COPD is difficult. ⋯ In adult patients with symptoms of AECOPD, an elevated serum CRP level of >19.6 mg/L indicates bacterial exacerbation. In patients with AECOPD with mucoid sputum, an elevated CRP level of >15.21 mg/L indicates bacterial infection, which may be a useful clinical marker for therapy of this disease.
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Review Meta Analysis
The role of TNF-α 308G>A polymorphism in the risk for ischemic stroke.
Stroke is a common health problem; however, its pathogenesis is not clear. Several studies have examined the association of -308G>A promoter polymorphism in the tumor necrosis factor-α gene (TNF-α) with ischemic stroke susceptibility. However, the results of these studies are inconsistent and the sample sizes of most of the studies were small. Thus, a meta-analysis was conducted to provide a more robust estimate of the effect of the TNF-α 308G>A polymorphism on the risk for ischemic stroke. ⋯ This study suggests that TNF-α 308G>A polymorphism is associated with the risk for juvenile ischemic stroke, whereas it is a protective factor for ischemic stroke in Asians and the adult population. However, in the overall analysis and in Caucasians, a significant association was not found.
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Oxidative stress has been implicated in the pathogenesis of cardiovascular disorders, including atherosclerosis. In pharmacological doses, niacin (vitamin B3) was proven to reduce total cholesterol, triglyceride, very-low-density lipoprotein, and low-density lipoprotein levels, and to increase high-density lipoprotein (HDL) levels. The aim of this study was to evaluate the effect of niacin treatment in patients with low levels of HDL cholesterol (HDL-C; <40 mg%) on their lipid profile and oxidative stress status. ⋯ Although serum CRP levels were not affected by niacin treatment, a correlation between CRP and HDL levels was obtained when computing the results. Niacin treatment in hypercholesterolemic patients with low HDL levels caused a significant decrease in their oxidative stress status. These results indicate an additional beneficial effect of niacin beyond its ability to affect the lipid profile.